疫情危機下的轉機？新冠肺炎大流行下推動專科護理師獨立作業之契機

Abstract

專科護理師角色越獨立，越可積極迎接現代社會之健康挑戰，包含醫療資源不均、高齡社會、以及傳染疾病大流行等問題。然而，台灣自專科護理師角色建立以來，各界對其獨立執業之範疇與程度，仍在尋求共識與更好的定位。眼下正值嚴重特殊傳染性肺炎（COVID-19）大流行，原本尚能勉力支撐之醫療資源恐迅速耗竭；如何以最具經濟效益之方法，穩定醫護量能，成為各界專注之焦點。故本文希望藉此契機，援引國際經驗及實證資料，論述專科護理師獨立執業之可能樣貌，及賦能專科護理師可對疫情與其他照護困境產生之正向影響。本文先簡述國內外專科護理師發展背景及執業現況，再從實證資料中分析，各國在COVID-19疫情期間，如何賦予或放寬專科護理師執業權限，進而直接或間接因應疫情衍生之醫療困境。最後，針對本土需求及現況提出建議，盼能藉此文章促進各方對於擴展專科護理師角色之討論及共識。  Higher nurse practitioner practice independence provides more effective solutions to modern health challenges such as health inequalities, aging society, and pandemic, etc. Nevertheless, consensus on nurse practitioners’ scope of practice is still underbuilding in Taiwan. While COVID-19 pandemic has drawn our attention towards cost-effective strategies to avoid system collapse, it is a great opportu­nity to redefine Taiwan nurse practitioner’s role in the pandemic and health care. Based on empirical evidence, the aim of this opinion paper is to critically describe what nurse practitioner independent practice is and how it can alleviate the burden on health system. We first presented the history and current status regarding nurse practitioners’ scope of practice in Taiwan and in other countries. Then we systematically discussed how governments in other countries temporarily expended or exempted the practice scope of nurse practitioner during the pandemic. We also commented on why nurse prac­titioners have the potential to solve healthcare resource shortages in difficult situations. Finally, we suggested to expend nurse practitioner’s role in Taiwan and hope to encourage relevant discussions and consensus building.